Working ability and use of healthcare resources for patients with trigeminal neuralgia treated via microvascular decompression.

Abstract

Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing and recurrent episodes of pain in one or more branches of the trigeminal nerve. In patients with TN refractory to medical therapy, microvascular decompression (MVD) is considered. TN interferes with daily functioning and is associated with depression and anxiety. Direct costs of MVD are high, but the procedure is believed to improve working ability and reduce the use of medical resources. This study aims to analyse MVD's effects on TN patients regarding work capacity, healthcare utilisation and health-related quality of life (hrQoL). We conducted a cross-sectional survey of patients who underwent MVD for TN between 2007 and 2016 (n = 46). The patients' outcome, work capacity and use of medical resources were assessed via the Barrow Neurological Institute Pain Intensity Score (BNI Score), with questions regarding patients' employment status, restrictions in work capacity, healthcare utilisation and completion of the EQ5D questionnaire. The response rate was 28/46 (61%). The majority of the participants (20/28) reported feeling strongly/quite handicapped in productivity due to TN preoperatively, which was also indicated by a few participants (3/28) postoperatively (p = < 0.01). Pain-related days off work were reduced postoperatively from 21 to 4 (p = 0.059) on average. Postoperative hrQoL did not differ from the general German population. Further reductions in healthcare utilisation and private costs were shown. In TN, MVD alleviates patient burden, especially concerning productivity and the consumption of health resources.